In Reflections on the Revolution in France, eighteenth century statesman Edmund Burke – often regarded as the father of modern conservatism – railed against the rejection of tradition and established institutions. His objection was not to reform itself but to radical changes enacted without the assurance of a viable alternative. Burke’s position could be summarised as advocating gradual, cautious reform thorough debate.
One wonders what Burke would make of the Terminally Ill Adults (End of Life) Bill that was passed, on its second reading, by 330 votes to 275 last Friday. Perhaps his own words of scepticism would resonate still:
“Men little think how immorally they act in rashly meddling with what they don’t understand. Their delusive good intention is no sort of excuse for their presumption. They who truly mean well must be fearful of acting ill.”
A cross-party divide
Given that 23 Tory MPs (including Rishi Sunak, Jeremy Hunt, and Mel Stride) voted in favour of a bill that is fundamentally anti-conservative is an indication of how complex, and cross-party, this issue is. It also raises questions as to whether ‘conservatives’ have strayed from the principles of conservatism.
Yet there are still voices that echo Burke’s caution: Danny Kruger, Conservative MP for East Wiltshire, warned parliament of potentially irreversible and damaging consequences of passing the bill:
“What are the safeguards for [people with complex needs]? I will tell you. We are the safeguard. This place. This parliament. You and me. We are the people who protect the most vulnerable in society from harm, and yet we stand on the brink of abandoning that role. The Rubicon was a very small stream, Mr Speaker, but on the other side lies a very different world, a worse world with a very different idea of human value.”
Lessons from the Netherlands
Kruger’s fears are not without precedent. The experience of the Netherlands, where assisted dying has been legal since 2002, provides a sobering example. In its first year of implementation, there were 1,882 assisted deaths. By 2023, this figure had risen to 9,068, accounting for 5.4% of all deaths in the country. To put this into perspective, an equivalent proportion in England and Wales would mean 86 assisted deaths per day.
The expansion of assisted dying in the Netherlands has also raised ethical concerns. The number of people euthanised for psychological suffering rose sharply by 20% from 2022 to 2023. While this has been legally permissible since the law’s inception, it remains deeply controversial. The legalisation of euthanasia for dementia patients further complicates matters, as doctors often face uncertainty about the patient’s state of mind.
Disturbingly, a significant percentage of Dutch doctors who performed euthanasia on dementia patients reported emotional repercussions (52%) and pressure from patients’ relatives (42%). One shocking case involved a Dutch woman held down by her family while a physician forcibly injected her with lethal drugs, despite her last-minute plea to revoke her advanced directive. Such incidents raise profound moral and ethical questions, including concerns about the Hippocratic Oath.
A divided parliament
Proponents of the bill likely have deeply personal reasons for their support. However, the substantial number of MPs voting against it reflects the divisiveness of the issue. The stance of the 18 MPs who abstained from voting is unclear, but for opponents of the bill, there is still hope. A reversal would require only 28 MPs to switch sides, and if reports by The Independent are accurate, 36 MPs have expressed a change of heart.
The road ahead
If the Terminally Ill Adults (End of Life) Bill eventually becomes law, one can only hope that its implementation does not pave the way to the proverbial road to hell. Burke’s warnings about the perils of well-intentioned but rash change remain as relevant today as they were in his own time.
Data sources:
The Netherlands: What’s The Situation? – Living and Dying Well
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